# STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851344220
- **Authorized official:** CARLA CASTANEDA (CHIEF DEPUTY DIRECTOR)
- **Authorized official phone:** (916) 654-2282

## Contact information

- **Practice address:** 15000 ARNOLD DRIVE, ELDRIDGE, CA 95431-1493
- **Practice address phone:** (707) 938-6000
- **Practice address fax:** (707) 938-6940
- **Mailing address:** 1215 O ST \# MS 10-30, SACRAMENTO, CA 95814-5804
- **Mailing address phone:** (916) 654-3463
- **Mailing address fax:** (916) 653-4587

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282E00000X | Long Term Care Hospital | — | NULL | — |
| 282N00000X | General Acute Care Hospital | 10000089 | CA | Yes |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 10000089 | CA | — |
| 314000000X | Skilled Nursing Facility | 10000089 | CA | — |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | 10000089 | CA | — |
| 333600000X | Pharmacy | 10000089 | CA | — |
| 3336L0003X | Long Term Care Pharmacy | HPE19573 | CA | — |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 01/24/2022